Active NPI
Jerry W Sonkens, MD
- Otolaryngology Physician
- SLC, UT
National Provider Identifier
1699734079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 159823-1205
- Practice address
- 4000 S 700 E
Ste 10
SLC, UT 84107-2180 - Phone
- (801) 268-4141
- Fax
- (801) 261-8609
- NPI assigned
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 159823-1205 | UT | Primary |
Addresses
Primary practice location
4000 S 700 E
Ste 10
SLC, UT 84107-2180
Mailing address
4000 S 700 E
Ste 10
SLC, UT 84107-2180
Phone (801) 268-4141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870354540001 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159823-1205 | UT | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1699734079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 S 700 E",
"address_2": "STE 10",
"city": "SLC",
"state": "UT",
"postal_code": "841072180",
"telephone_number": "801-268-4141",
"fax_number": "801-261-8609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 S 700 E",
"address_2": "STE 10",
"city": "SLC",
"state": "UT",
"postal_code": "841072180",
"telephone_number": "801-268-4141",
"fax_number": "801-261-8609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONKENS",
"first_name": "JERRY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "UT",
"license": "159823-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "870354540001",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in SLC, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.